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Organization

MEDICINE SHOPPE

Active
Organization subpart
No

Provider details

NPI number
Authorized official
BRIAN CONERTY RPH (OWNER PHARMACIST)
(732) 367-5080
Entity
Organization

Contact information

Practice address
681 RIVER AVE, LAKEWOOD, NJ 08701-5229
(732) 367-5080
(732) 367-5734
Mailing address
681 RIVER AVE, LAKEWOOD, NJ 08701-5229
(732) 367-5080
(732) 367-5734

Taxonomy

Speciality
Code
Description
License number
State
333600000X
Pharmacy
3336C0003X
Community/Retail Pharmacy
Primary
RS00614000
NJ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
3120627
OTHER ID NUMBER
05
9004408
NJ
Enumeration date
08/03/2006
Last updated
03/07/2023
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